The emergency department waiting room was packed as always as patients were, as if they were sitting for hours, crammed closely into hard metal chairs. Only people who had immediate care, like a heart attack, were immediately seen.
One man was enough. He slammed the glass window in front of the receptionist before raiding. When he left, he took a smoking break and attacked the nurse. “Are you working so hard?” he called as he left.
No, the event wasn't real, but it was an art similar to the life of the Max series “The Pitt,” which streams the season finale on Thursday. The show will be held in the fictional Pittsburgh Hospital emergency room. But the underlying theme – a terrifying overcrowding – is universal in this country. And it's not easy to fix.
“EDS is upset and overwhelmed,” the U.S. Emergency Clinic reported in 2023, referring to the emergency department.
“This system is at its breaking point,” said Dr. Benjamin S. Abela, chairman of the Icahn School of Medicine at Mount Sinai in New York.
“The Pitt” lasts for an hour per day, as emergency room doctors, nurses, medical students, custodians and staff deal with all sorts of medical issues. There were patients with heart attacks and strokes, overdose, severe burns, and influencers who had heavy metals poisoned in their skin cream.
As this is TV, many of the annoying issues are neatly resolved in 15 episodes of the show. Her older mother apologises as the woman fell asleep as she seemed to have returned. Parents whose son died from an accidental fentanyl overdose come to donate his organs. The pregnant teenager and her mother come to the resolution following a wise doctor's lawyer in conflict over medical abortion.
However, again and again, images are from systems that operate beyond capacity. There is a jammed waiting room and a “border”. Patients have parked in emergency rooms and hallways for more than a few days, as they do not have hospital beds. (The American College of Emergency Medicines is calling for people to board the “National Public Health Crisis.”
I'm looking forward to a simple test. There is medicine in the hallway. This is because in the hallway, patients who are seen in the hallway, not patients who meet the doctor in the hallway, but patients who are seen in the hallway have no other place to be placed.
And violence like men who have had mental problems and nurses punched violence, verbal and physical violence.
“The “pit” indicates that the system is below,” Dr. Abela said. “I watch it every day across the country.”
But why can't I fix this issue?
There is no simple solution, says Dr. Ezekiel J. Emmanuel, co-director of the Institute for Health Change at the University of Pennsylvania Perelman School of Medicine. The problem was, “It's multiplexed and there's no magic wand.”
A part of that is money.
Patients are clogged in the emergency room, ensuring that beds that do not enhance hospital revenue will not be unused.
Next is the issue of draining patients. Due to the lack of space in nursing homes and rehabilitation centres, patients ready to leave the hospital often wait for the space to open elsewhere.
The schedule is another challenge, said Dr. Jeremy S. Faust, who is part of the doctors at Brigham and Women's Hospital's Emergency Medical Office. Many rehabilitation centers only accept patients during opening hours, he said. If an ER patient is ready to be discharged over the weekend, the patient must wait.
Like in real life, in the “pits,” patients often appear in problematic emergency rooms, like children with ears. Why not go to their doctor instead of being able to watch for hours?
One reason is that “primary care goes to hell with a hand basket,” said Dr. Emmanuel.
In many cities, finding a primary care physician can be difficult. And even if you have it, it can take days or weeks to get an appointment.
Many people don't want to wait.
“Modern mentality, for better or worse, will look for another solution if you can't get it now,” Dr. Abela said.
It often means emergency room.
Building larger emergency rooms is not aiding overcrowding.
Dr. Faust said his hospital opened a new emergency room several years ago with a significant increase in bed numbers. The colleague who gave him a tour proudly told him that he probably wouldn't have more patients in the hallway.
“I looked at him and said, 'bwhahahaha,'” Dr. Faust said. “If you build it, they'll come.”
He was right.
